This is because the cost of staffing a public home is greater, according to consultant geriatrician Dr Christine O’Malley.
“Private homes are obliged by law to have one trained nurse. Public homes tend to run on a trained nursing staff which is why they can take on the more dependent patients,” Dr O’Malley said during a debate on the practical difficulties of the new scheme at the AGM of the Irish Medical Organisation (IMO) in Killarney, held over the weekend.
Prof Cillian Twomey, consultant physician in geriatric medicine at Cork University Hospital, said he had issues with the complexities in applying for the scheme, now the “only show in town” for those accessing long-term care. “Forty per cent of those identified as needing long-term care are suffering from an illness that precludes them from not only reading, but understanding the application form,” Prof Twomey said.
He said the scheme, described as ‘Fair Deal’ was not fair, and you now had a situation where someone who lived prudently and managed their financial affairs had no advantage over “someone who lives for the day and ends up with no money”.
Prof Twomey said the situation was further complicated by the fact that because anyone in need of long-term care now had to first undergo medical and financial assessment, in cases where beds were available, they could not be discharged from hospital until the assessments were complete.
The issue of co-location was also debated. Prof John Higgins, consultant obstetrician at Cork University Maternity Hospital, said he supported it on the grounds it would add 200 hospital beds to the system in the Health Service Executive (HSE) South.
Dr Chris Luke, consultant in emergency medicine, said co-location “enshrines the unfairness of the two-tier system,” but Prof Higgins said consultants had flourished in that two-tier system.
Dr O’Malley, consultant geriatrician at Nenagh General Hospital, said one of her major worries about reconfiguration was that, with the centralisation of surgical services in the bigger hospitals, anaesthetists would also transfer, leaving medical patients in the smaller hospitals with no access to an anaesthetist.
However, Dr John Kennedy, consultant anaesthetist at the Mid West Regional Hospital, said discussions were ongoing to address this issue.